Community seroprevalence survey for yaws and trachoma in the Western Division of Fiji.

Naomi Cocks,Mike Kama,Robert Butcher,Merelesita Rainima-Qaniuci,David Mabey,Colin Macleod,Stephanie Migchelsen,Michael Marks,Chrissy H Roberts,Chelsea Yalen,Apisalome Nakolinivalu

doi:10.1093/trstmh/trw069

Abstract

BackgroundBoth yaws and trachoma are endemic in several countries in the Pacific. In co-endemic countries there may be potential synergies between both control programmes.MethodsWe undertook a cluster randomised trachoma and yaws seroprevalence survey of children in the Western Division of Fiji. Children were examined for skin lesions consistent with active yaws. A dried blood spot was collected which was tested using the Treponema pallidum particle agglutination (TPPA) test and an ELISA to detect antibodies against Pgp3.ResultsA total of 607 children from 305 households across 23 villages were recruited into the survey. On skin examination, no child had clinical evidence of yaws, and the TPPA assay was negative in all children (0%, 95% CI 0.0–0.6). The seroprevalence of Pgp3 antibodies was 20.9% (95% CI 17.8–24.6%).DiscussionIn this study there was neither clinical nor serological evidence that transmission of yaws was ongoing. The Pgp3 seroprevalence pattern was consistent with either low level transmission of ocular Chlamydia trachomatis or exposure to C. trachomatis in the birth canal which is consistent with a survey conducted in the same region in 2013. These data suggest neither yaws nor ocular chlamydia infection are a significant public health problem in the Western Division of Fiji.

Highlights

Yaws, caused by Treponema pallidum subsp. pertenue, is endemic in several countries in the Pacific.[1]
We found no evidence that yaws was still endemic in the Western Division of Fiji
No children were identified with clinical evidence of yaws and treponemal antibody testing was negative in all children

Summary

Introduction

Yaws, caused by Treponema pallidum subsp. pertenue, is endemic in several countries in the Pacific.[1]. WHO has targets for both the global eradication of yaws and elimination of blinding trachoma as a public health problem by 2020.4,5 Central to the strategy for both of these targets is the use of community mass treatment with azithromycin, which is an effective therapy for both organisms. In countries where both yaws and trachoma are endemic there may be potential synergies between the control programmes at multiple levels including survey, intervention and surveillance.[6,7]. In co-endemic countries there may be potential synergies between both control programmes

Methods

Results

Conclusion